Speech pathologists working with adults who stutter: let’s open our ears and minds
The problem:
Speech-language pathologists (SLPs) argue with each other about the “best” or “most evidence-based” approach to support adults who stutter. Many SLPs are trained in a particular therapy approach and use it with every client. Others start with a model that appeals most to their personal world view, and deliver therapy with goals dictated by the model.
Why it matters:
Sometimes, SLPs get so focused on their preferred model of care, program, or approach, that they exhibit a cognitive bias called Maslow’s hammer. (If the only tool you have is a hammer, you are tempted to treat everything as if it were a nail.) When you do this, you forget the most important thing: what your client actually wants!
Zoom in:
Different people who stutter come to SLPs seeking a variety of evidence-based supports, including:
- affirmation that stuttering is common, doesn’t need to be concealed, and is nothing to be ashamed about;
- education about what stuttering is (and isn’t);
- coaching in particular fluency-enhancing techniques to consider in specific challenging or frustrating situations (e.g. for job interviews);
- communication training to build general confidence to speak when stuttering (e.g. for meetings, debates, or community talks);
- speech restructuring to learn a speech pattern to speak without or without much obvious stuttering;
- connections with other people who stutter (e.g. to mentors and self-help groups and communities) and to other health professionals who can help;
- connections with mental health professionals, e.g. for help with social anxiety and mental health;
- advocacy, e.g. in workplaces, or for work accommodations or adjustments; and/or
- medico-legal opinions, e.g. in workplace disputes or discrimination claims.
People > models:
SLPs must (of course) understand medical and social models of stuttering, and the latest research. But they must not confuse models with reality, or seek to impose a single approach on clients. Instead, they should:
- listen to their clients to understand their objectives;
- provide unbiased information about options, and risks and benefits of different approaches, to help clients achieve their goals; and
- challenge themselves to keep an open mind and to learn about new approaches that conflict with their original training.
Practising what I preach:
Last week, I read a peer-reviewed study about an approach called “Multidimensional Individualised Stuttering Therapy” developed by researchers in Norway and the UK (see below). Although the study lacked a control group, or enough detail to replicate the treatment with confidence, it contained some useful and practical ideas about mindfulness-based strategies (self-compassion, acceptance without judgment), collaborative goal-setting, and personalised care that help me to expand my toolkit and improve the way I listen to and work to support an adult who stutters.
Read more:
Multidimensional Individualized Stuttering Therapy Outcomes At 24 Months Post Clinic: An Embodiment and Awareness Perspective (Open Access)
Stuttering therapy: going beyond medical models
Hi there, I’m David Kinnane.
Principal Speech Pathologist, Banter Speech & Language
Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.
